Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 30;12(11):2493.
doi: 10.3390/biomedicines12112493.

The Progression of Symptoms in Post COVID-19 Patients: A Multicentre, Prospective, Observational Cohort Study

Merel E B Cornelissen  1   2   3 , Myrthe M Haarman  1 , Jos W R Twisk  4 , Laura Houweling  1   2   3   5 , Nadia Baalbaki  1   2   3 , Brigitte Sondermeijer  6 , Rosanne J H C G Beijers  7 , Debbie Gach  7 , Lizan D Bloemsma  1   2   3 , Anke H Maitland-van der Zee  1   2   3 ; P4O2 Consortium
Affiliations

The Progression of Symptoms in Post COVID-19 Patients: A Multicentre, Prospective, Observational Cohort Study

Merel E B Cornelissen et al. Biomedicines. .

Abstract

Background: Although the coronavirus disease 2019 (COVID-19) pandemic is no longer a public health emergency of international concern, 30% of COVID-19 patients still have long-term complaints. A better understanding of the progression of symptoms after COVID-19 is needed to reduce the burden of the post COVID-19 condition.

Objective: This study aims to investigate the progression of symptoms, identify patterns of symptom progression, and assess their associations with patient characteristics.

Methods: Within the P4O2 COVID-19 study, patients aged 40-65 years were recruited from five Dutch hospitals. At 3-6 and 12-18 months post COVID-19, medical data were collected, and pulmonary function tests were performed. In between, symptoms were assessed monthly with a questionnaire. Latent class mixed modelling was used to identify symptom progression patterns over time, with multinomial logistic regression to examine associations with patient characteristics.

Results: Eighty-eight patients (aged 54.4 years, 48.9% males) were included. Three trajectories were identified for fatigue and dyspnoea: decreasing, high persistent, and low persistent. The odds of "decreasing fatigue" was higher for never smokers and participants in the lifestyle intervention and lower for those having a comorbidity. The odds of "decreasing dyspnoea" was higher for moderate COVID-19 patients and lifestyle intervention participants and lower for males, mild COVID-19 patients, and those with a higher age.

Conclusions: Three distinct trajectories were identified for fatigue and dyspnoea, delineating patterns of symptom persistence following COVID-19. Sex, age, smoking status, participation in lifestyle interventions and COVID-19 severity were associated with the likelihood of belonging to different trajectories. These findings highlight the heterogeneity of the long-term symptoms experienced by post COVID-19 patients and emphasise the importance of personalised treatment strategies.

Keywords: dyspnoea; fatigue; post COVID-19 condition; symptom progression; trajectories.

PubMed Disclaimer

Conflict of interest statement

MMH, JWRT and BS—the authors declare no conflict of interest. MEBC, LH, NB, RJHCGB, DG and LDB—public and private partners in the P4O2 consortium, as listed under ‘Funding’. AHM—PI of a public private consortium (P4O2 (Precision Medicine for More Oxygen)) sponsored by Health Holland, involving many private partners that contribute in cash and/or in kind (AbbVie. Boehringer Ingelheim, Breathomix, Clear, Fluidda, Ortec Logiqcare, Olive, Philips, Quantib-U, Smartfish, Clear, SODAQ, Thirona, Roche, TopMD, Novartis, RespiQ); received unrestricted research grants from GSK and Boehringer Ingelheim; received Vertex Innovation Award grant; honoraria paid to Institution from Boehringer Ingelheim, Astra Zeneca and GSK; chair of a DSMB of a study on BPD in neonates.

Figures

Figure 1
Figure 1
Three trajectories based on the weekly frequency of fatigue from month 4 to month 18 after SARS-CoV-2 infection. Each red line represents a patient and each blue line represents a trajectory.
Figure 2
Figure 2
Three trajectories based on the weekly frequency of dyspnoea from month 4 to month 18 after SARS-CoV-2 infection. Each red line represents a patient and each blue line represents a trajectory.
See this image and copyright information in PMC

References

    1. World Health Organization WHO Coronavirus (COVID-19) Dashboard. 2022. [(accessed on 19 April 2024)]. Available online: https://covid19.who.int/
    1. Daher A., Balfanz P., Cornelissen C., Muller A., Bergs I., Marx N., Muller-Wieland D., Hartmann B., Dreher M., Muller T. Follow up of patients with severe coronavirus disease 2019 (COVID-19): Pulmonary and extrapulmonary disease sequelae. Respir. Med. 2020;174:106197. doi: 10.1016/j.rmed.2020.106197. - DOI - PMC - PubMed
    1. World Health Organization . A Clinical Case Definition of Post COVID-19 Condition by a Delphi Consensus, 6 October 2021. World Health Organization; Geneva, Switzerland: 2021.
    1. Liska D., Liptakova E., Babicova A., Batalik L., Banarova P.S., Dobrodenkova S. What is the quality of life in patients with long COVID compared to a healthy control group? Front. Public Health. 2022;10:975992. doi: 10.3389/fpubh.2022.975992. - DOI - PMC - PubMed
    1. Raveendran A.V., Jayadevan R., Sashidharan S. Long COVID: An overview. Diabetes Metab. Syndr. 2021;15:869–875. doi: 10.1016/j.dsx.2021.04.007. - DOI - PMC - PubMed

Grants and funding

LinkOut - more resources